Living and working with sickness: a qualitative study.

OBJECTIVES

To explore patients' views and experiences of long-term sickness absence, and their attitudes with regard to return to work.

METHODS

The study design and analysis were guided by a narrative psychology perspective. In-depth, biographical narrative interviews were conducted with 26 individuals, aged between 30 and 65 years, who had been certified absent for longer than 6 weeks. Follow-up data were collected at 12 months. The narrative analysis techniques used were holistic content, holistic form, categorical content, and categorical form. This paper illustrates our findings obtained mainly using the holistic-form approach.

RESULTS

Long-term absence reduces attachment to work and impacts on work identity. Three distinct narrative patterns emerged from the data analysis. The first was 'uncomplicated absence', usually triggered by an acute event with an uncomplicated resolution; the second, 'complicated absence', typically involved gradually deteriorating health and social complications with a less predictable recovery; the third pattern, 'sustained absence', was associated with chronic deterioration in health, often complex and multidimensional in nature. These three patterns offer an insight into how well individuals are coping with their underlying health condition.

CONCLUSIONS

Narrative analysis tools could be developed to help identify those patients who would: (1) respond favourably to 'return to work' interventions; or (2) benefit from additional health service support.